Scabies

Sarcoptes scabiei var. hominis, the human itch mite

Every year, the American Camp Association Camp Crisis Hotline receives calls from camps that have questions about scabies. Either they have detected scabies on a camper or staffer, or they are preparing for an infestation — should it occur — and want some advice. Camps are looking for resources, guidelines, and products to help them. ACA shares our lessons learned from years of helping camps:

Top Four Tips for Camps

Ensure that the health care, nursing, and medical staff at your camp are familiar with scabies infestation diagnosis and treatment options prior to camp opening for the season.

Establish and enforce excellent camp policies regarding personal health and the prevention of the spread of communicable diseases. Understand that the first time a person gets scabies they usually have no symptoms during the first 2 to 6 weeks they are infested; however, they can still spread scabies during this time. So, it is important that your camp establish responsible procedures that break the “chain of communicability.”

Establish treatment, prevention, and control procedures based upon expert advice (such as the recommendations from the Centers for Disease Control and Prevention [CDC]).

Establish a policy about who you will inform if an infestation occurs. Be prepared with key messages and facts (see below for resources).

What Is Scabies?

Scabies is a common skin infection that causes small itchy bumps and blisters due to tiny mites (Sarcoptes scabiei var. hominis) that burrow into the top layer of human skin to lay their eggs. The burrows sometimes appear as short, wavy, reddish, or darkened lines on the skin's surface, especially around the wrists and between the fingers. The microscopic mite that causes scabies can barely be seen by the human eye. Being a tiny, eight-legged creature with a round body, the mite burrows in the skin. Within several weeks, the patient develops an allergic reaction causing severe itching; often intense enough to keep sufferers awake all night. The most common symptoms of scabies are intense itching and a pimple-like skin rash. Scabies is contagious, and is usually transmitted by skin-to-skin contact or through sexual contact with someone else who is infected.

Signs and Symptoms of Scabies

The most common symptom of scabies is severe itching, which may be worse at night or after a hot bath. A scabies infection begins as small, itchy bumps, blisters, or pus-filled bumps that break when you scratch them. Itchy skin may become thick, scaly, scabbed, and crisscrossed with scratch marks. The areas of the body most commonly affected by scabies are the hands and feet (especially the webs of skin between the fingers and toes), the inner part of the wrists, and the folds under the arms. It may also affect other areas of the body, particularly the elbows and the areas around the breasts, genitals, navel, and buttock.

How Scabies Is Spread

The microscopic scabies mites are almost always passed by direct, prolonged, skin-to-skin contact with a person who already is infested. An infested person can spread scabies even if he or she has no symptoms. The first time a person gets scabies they usually have no symptoms during the first two to six weeks they are infested; however, they can still spread scabies during this time. Humans are the source of infestation; animals do not spread human scabies. Scabies mites generally do not survive more than two to three days away from human skin.

Treatment

Products used to treat scabies are called scabicides because they kill scabies mites; some also kill mite eggs. Scabicides used to treat human scabies are available only with a doctor’s prescription. No “over-the-counter” products have been approved to treat scabies. Scabicide lotion or cream should be applied to all areas of the body from the neck down to the feet and toes. In addition, when treating infants and young children, scabicide lotion or cream also should be applied to their entire head and neck because scabies can affect their face, scalp, and neck, as well as the rest of their body.

Bedding, clothing, and towels used by infested persons or their close contacts (such as cabin mates) anytime during the three days before treatment should be decontaminated by washing in hot water and drying in a hot dryer, by dry-cleaning, or by sealing in a plastic bag for at least 72 hours. Scabies mites generally do not survive more than two to three days away from human skin.